COMPARISON BETWEEN DEXAMETHASONE AND DEXMEDETOMIDINE AS AN ADJUVANT IN TRANSVERSE ABDOMINAL PLANE (TAP) BLOCK FOR POSTOPERATIVE ANALGESIA IN PATIENTS OF CAESAREAN SECTION

Background: Patients usually suffer from significant pain after caesarean section, with the major source of pain being the anterior abdominal wall and the abdominal viscera. [1] These patients require a multimodal postoperative treatment regimen that provides high-quality analgesia with minimal side effects. The Transversus Abdominis Plane (TAP) block is a regional anaesthesia technique that targets the sensory nerve supply of the antero-lateral abdominal wall and has been proven as an effective method to reduce postoperative pain and analgesic consumption for caesarean section surgeries in various clinical trials. [2,3] Various adjuvant has been used to intensify the quality and prolong the local anaesthetic effect. [4,5] Objective: To compare Dexamethasone and Dexmedetomidine as adjuvant to local anaesthetic in TAP Block for postoperative analgesia in patients with caesarean section. To assess the time for the first request of analgesia Methodology: The study was a Randomised Control Trial done in the Department of Anaesthesiology and the Department of Obstetrics and Gynaecology of Government Medical College and Hospital, Akola. The study was performed over a time period of 16 months (October 2022 to February 2024). The total sample size taken was 100 (50 in each group) with the help of Randomisation (lottery method). Group A received a total of 40 mL of Inj Bupivacaine hydrochloride 0.25% + 2 mL Dexamethasone (8 mg). Group B received a total of 40 ml of Inj Bupivacaine hydrochloride 0.25% + 0.5 mcg/kg of Dexmedetomidine (Max Bupivacaine dose- 2mg/kg in both cases). The total dose was divided into two parts to be given on each side, equally. Result: The study found that Dexmedetomidine was more effective when compared to Dexamethasone in providing better outcomes in terms of VAS scores and duration of the analgesia. The mean time of request for first analgesia in the Dexmedetomidine group was significantly greater (19.66 hrs) than in the Dexamethasone group (12.10 hrs).  Conclusion: Overall, the study proved that Dexmedetomidine was more effective when compared to Dexamethasone when added as an adjuvant with better outcomes in VAS scores and duration of the analgesia.